Death Zone, Nepal

Destination 17: Death Zone, Nepal

The Tourism Ministry of Nepal recently (2014) announced that the flow of expedition teams on Mount Everest would only be allowed in May when the weather is favorable for the climb above 26,240 ft. Climbers refer to this section as the ‘death zone’ because of the hostile conditions and the fact that there is little chance of rescue.

Related Film: Devil’s Pass (2013)


Devil’s Pass is a 2013 science fiction horror film shot in the style of found footage set to the Dyatlov Pass incident: the unsolved deaths of nine hikers in the Ural Mountains (Russia) in February 1959.

Holly and Jensen lead 5 Oregon college students to find out what happened to 9 hikers who mysteriously died in the Dyatlov Pass incident. After Holly hears howling at their camp site, the group finds footprints in the snow that lead Jensen to claim they are being hunted by the yeti, thus merging the hostile conditions that confer little chance of rescue with the abdominal cryptid.

How it relates to the field of psychiatry

The yeti is a cryptid; an animal whose existence or survival is disputed or unsubstantiated. While Holly and Jensen believe they’ve come into contact with the yeti while exploring the Ural Mountains in Russia, the creature is said to inhabit the Himalaya Mountains in Nepal.

The French anthropologist, Claude Lévi-Strauss, identified myths as a type of speech through which a language could be discovered. He is renowned for his structuralist theory of mythology which attempted to explain how fantastical tales could be so similar across cultures. Urban legends are cautionary tales of contemporary folklore that identify taboos represented in all cultures that capture four common themes: a) misunderstandings, b) poetic justice, c) business rip-offs, and d) revenge. Urban legends are a large part of popular culture and often speak to the fears, anxieties, and biases of a culture such as that of the Sherpa. In doing so, folkloric tales provide insight into the moral fabric of the culture. The creation of the yeti for example may be the Nepalese means to rationalize the misunderstandings (e.g. missing persons) associated with the Death Zone.

Anthony Tobia, MD, Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

The Building in Alexandria, Egypt

Destination 15: The Building in Alexandria, Egypt


It is said that the Building in Alexandria was cursed during construction and that is why supernatural happenings occur there. It is also said that there was once a cop was burnt in the building while he was attempting to prove to the residents that nothing resides in the building. Nobody really knows the true story, but what we do know is that disembodied screams are often heard from inside at night.

Related Film: The Mummy (1932, 1999)


The 1999 film, The Mummy, a remake of the 1932 film of the same name, tells the story of Imhotep, a high priest of Pharaoh Seti I, who witnesses his love and Pharaoh’s mistress, Ancksu-Namun, commit suicide to protect him after they are caught having an affair. Imhotep, while trying to revive her (an act considered heinous by the high priests) is sentenced to be mummified alive. In addition to this death, a curse was placed on him, stating that if anyone finds and opens the chest containing the Book of the Dead, death will come quickly to them by the hand of the undead. After two teams of adventurers find both the chest and the coffin of Imhotep, the mummy is awakened and journeys to fulfill the curse. Meanwhile, he believes that one of the adventurers, Evelyn, is a possible reincarnation of his love and tries to sacrifice her to finally revive Anck-su-Namun. The adventurers must then find a way to defeat Imhotep before he kills Evelyn and destroys the world.

How the movie relates to the field of psychiatry

The concept of the mummy, first introduced in the novel The Jewel of Seven Stars, provides an interesting perspective of psychotic disorders, which is on full display in the 1999 version of the film. Guarding the tomb where the chest and Imhotep’s coffin lay is a group called the Medjai. This group exemplifies the concept of the culture-bound syndrome, as they not only believe wholeheartedly in the curse but also in their role in preventing Imhotep’s revival. The psychosis extends to the group of adventurers who, although the curse never names Imhotep as the “undead” who will enact the curse, strongly believe he is. Reading from the Book of the Dead, the adventurers begin to hallucinate that Imhotep has awakened and is attacking Egypt with the 10 plagues, beginning with turning a fountain water into blood. Throughout the film, their hallucination that Imhotep is taking the body parts of others to regenerate himself, such as the eyes and tongue from one adventurer, is called Cotard syndrome.

The 1932 version of the film also manifests dissociative disorders, particularly Dissociative Identity Disorder. Both the characters of Evelyn (in the 1999 film version) and Helen (1932) are believed by Imhotep to be the current reincarnation of Anck-su-Namun. Despite Evelyn maintaining her identity, Helen manifests an altered, distinct personality state when she exclaims that Anck-su-Namun’s life is inside her and “is fighting for life.” While taking on the personality of Anck-su-Namun, Helen is unable to remember aspects of her life (e.g. taking care of her dog or how she is unaware of how she returned home). While this may be attributed to delirium (her physician claims she is suffering from exhaustion), Helen is seen awakening and taking on the personality and regalia of Anck-su-Namun despite having been treated for exhaustion, thus suggesting a primary mental disorder of Dissociative Identity Disorder.

Marez Megalla, Anthony Tobia, MD, Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Kawah Ijen, Indonesia

Destination 18: Kawah Ijen, Indonesia

Kawah Ijen is an active volcano in Indonesia. Miners scale the 8,660ft Kawah Ijen volcano up to the crater, then down to the shore of a huge crater lake of sulfuric acid where they retrieve heavy chunks of pure sulfur. Active volcanoes in Indonesia have long been part of our world folkloric history.

Related Novel: Frankenstein (June 1816)


In April 1815, another volcano on an Indonesian island exploded. With an estimated 25 cubic miles of Mt. Tambora’s debris ejected into the stratosphere, it was the largest eruption in the last 10,000 years. The stratospheric cloud that stretched around the earth lead to unprecedented climate change in many parts of the world.

As depicted in the movie, Gothic (1986), Mary Godwin, Percy Shelley, Lord Byron, Claire Clairmont, and a young physician named John William Polidori rented a villa in Cologny, Switzerland in 1816. As a result of the seismic activity from Mount Tambora, an “incessant rain” confined the group in the house for days which spawned discussions on varied topics including galvanism and the reanimation of dead matter. The company also amused themselves by reading German ghost stories, prompting Byron to suggest they each write their own supernatural tale. Shortly after, the iconic monsters from Frankenstein (Shelly) and The Vampyre, a Tale (Polidori) were conceived.

202 years ago on June 6, 1816, Mary Shelley had a waking dream of her creation: Frankenstein’s monster. A biographical analysis of Mary Shelley frames Frankenstein as a work of sublimation, with each character representing a major archetype of the author’s collective unconscious (Table 1). The supernatural tale may be referenced by course directors in psychology and psychiatry to introduce psychodynamic theories of personality.

Table 1. Characters in Mary Shelley’s Frankenstein representing archetypes of Jung’s Collective Unconscious

Character Jungian Archetype Description
Frankenstein’s Monster Shadow The Shadow houses our most base and primal instincts like an author’s desire to kill her father/creator.
Robert Walton (narrator) Self Representing the unification of the conscious and unconscious, the Self is represented by Walton, the narrator of the story.
The Syzygy (divine couple): Victor & Elizabeth
Viktor Frankenstein Animus The Animus is the male image in the female (Shelley’s) psyche. For the female author, Victor plays a more prominent role than Elizabeth.
Elizabeth Lavenza Anima The Anima is a feminine image in the male psyche and is the weaker character for the female author.



Lore, podcast,

Psychiatry taught through the lens of film and natural history,

Anthony Tobia, MD. Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Killing fields, Cambodia

Destination 19: Killing fields, Cambodia

The Killing Fields are a number of sites in Cambodia where more than a million people were killed and buried by the Khmer Rouge regime during its rule from 1975 to 1979 (

Related FilmA Nightmare on Elm Street (1984)

A Nightmare on Elm Street (1984) was based on a true story (

The narrative device of Wes Craven’s slasher film, in which knife-for-fingers Freddy Krueger (Robert Englund) kills innocent teenagers in their sleep, is entirely fictionalized. However, Craven based the movie on a Los Angeles Times article.

Craven described the idea for the premise of A Nightmare on Elm Street:

“I’d read an article in the LA Times about a family who had escaped the Killing Fields in Cambodia and managed to get to the U.S. Things were fine and then suddenly the young son was having very disturbing nightmares. He told his parents he was afraid that if he slept, the thing chasing him would get him, so he tried to stay awake for days at a time. When he finally fell asleep, his parents thought this crisis was over. Then they heard screams in the middle of the night. By the time they got to him, he was dead. He died in the middle of a nightmare. Here was a youngster having a vision of a horror that everyone older was denying. That became the central line of Nightmare on Elm Street.”


A Nightmare on Elm Street is a slasher film set in the fictional town of Springwood, Ohio. The plot revolves around Nancy and her teenage friends who are stalked and killed in their dreams by the omnipresent, blade-gloved Freddy Krueger. The reason behind Freddie’s rampage lies in the parents’ sinister secret from years ago.

The greatness of Craven’s film is that the identification with the characters doesn’t end with the movie’s final scene. Instead, it continues following the movie. As anyone whose had a nightmare after watching this film will attest, it’s the moment after you wake up from the terrifying dream that is most horrifying, as it is then that you’re put in the exact same position as the main characters.

Interestingly, the opening scene of Shadow People (2013), a supernatural thriller written and directed by Matthew Arnold, is set in 1979 Cambodia, the final year of the Khmer Rouge regime. Arnold’s film addresses the universal fear of the boogieman, linking to the multiple psychiatric themes in Wes Craven’s A Nightmare on Elm Street (Nightmare).

How it relates to the field of psychiatry

As the title implies, A Nightmare on Elm Street (Nightmare) depicts Nightmare Disorder (ND); repeated awakenings with recollection of terrifying dreams usually involving threats to survival such as being hunted by a child murderer. Upon awakening from her nightmares, Nancy is alert and able to recall her dream in detail, thus reinforcing the teaching point that differentiates ND from Sleep Terror Disorder. With sleep terrors, there is no detailed recall of the dream. While the above sleep disorders (parasomnias) are in the differential diagnosis for what ails the teenagers in the film, so too is a dyssomnia.

Dyssomnias are disturbances in the quality, amount, or timing of sleep. While a discussion of sleep stages is beyond the scope of this blog, the movie is about a recurrent nightmare (REM sleep) that invades the teenagers’ wakeful states. In this way, Nightmare is a metaphor for a dyssomnia defined by REM invasion into the beta state (wakefulness), specifically, Narcolepsy. Narcolepsy usually has its onset in adolescence (e.g. Nancy), is characterized by hallucinations (seeing the boogeyman), and is genetically predisposed. Metaphorically, Nancy and her friends carry the (genetic) burden of their parents.

While it is established that Freddie Krueger was a child murderer, the backstory is that he’s afflicted with Pedophilic Disorder. His having a paraphilia provides depth to the character of Nancy Thompson. Tina, Glen, and Rod are all murdered in bed, the location being symbolic of Freddie’s sexual disorder. While the history of Freddie as a child murderer is ultimately provided by her mother, Nancy’s discovery is metaphorical of the recovery of her lost memories. When Freddie is pursuing her, she runs to the basement of her home which looks distorted, a product of derealization likely due to anxiety. Given the film’s ability to transgress “the boundaries between the imaginary and real,” Nancy’s experience in the basement may be a nightmare (sleep) or a flashback (wakefulness) that is cued by the situation. Specifically, she was likely imprisoned in Freddie’s boiler room (basement). Unlike the other characters, Nancy is “kept alive” by Freddie, and slowly learns the truth/etiology of her nightmares. Freddie considered her special in some respect. Nancy’s mother, Marge, kept Freddie’s hat and glove; bizarre behavior if Freddie was “just a child murderer.” Years prior, Marge likely had an affair with Fred Krueger (which would be consistent with her having separated from her husband in present day), but had a blind eye to her boyfriend’s conduct towards her daughter. Nancy and her friends are victims of the sins of their parents.

Nightmare then is not merely about Sleep and Awake Disorders such as Nightmare Disorder or Narcolepsy. Nancy’s sleep pathology is likely due to Posttraumatic Stress Disorder, having been a victim of childhood sexual abuse.

Anthony Tobia, MD, Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Erta Ale, Ethiopia

Destination 16: Erta Ale, Ethiopia


Erta Ale is a remote and rarely visited shield volcano in the Afar region of East Africa. Erta Ale is known to have an active lava lake in its summit crater and is surrounded by sulfur pits. Erta Ale has undergone seven eruptions in the past 125 years and has been erupting continuously since 1967.

Related Film: Aladdin (1992)


The location as well as the name of the region (Afar) of East Africa loosely references the villain in Aladdin (1992). Aladdin is a 1992 animated musical produced by Walt Disney Pictures based on the folktale of the same name from One Thousand and One Nights. Jafar is the grand vizier of Agrabah and the main antagonist in the film.

Jafar identifies a street urchin named Aladdin to retrieve a lamp hidden within the Cave of Wonders. Upon its discovery, Aladdin rubs the lamp, releasing its mystical vapors and all the adventures that follow including befriending a genie, flying on carpets, and becoming a prince.

How it relates to the field of psychiatry

Given the contents of the lamp (vapors), one could view One Thousand and One Nights as a hallucinogenic trip caused by inhalant exposure. As such, the adventures that befall Aladdin may be interpreted as psychological symptoms of inhalant intoxication. The physiologic signs of inhalant intoxication can be remembered by magic carpet rides (acronym).

Muscle weakness

Coma or stupor
Ataxia (unsteady gait)
Reflexes depressed
Psychomotor retardation

Rotary nystagmus
Dizziness; Diplopia
Energy decreased or lethargy
Slurred speech

Anthony Tobia, MD. Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Poveglia Island, Italy

Destination 12: Poveglia Island, Italy


“In the South Lagoon between Venice and Lido sits the small Italian island of Poveglia that for centuries has been a refuge, stronghold, place of exile, and a dumping ground for the diseased, dying, and deceased.” The island is considered to be the most haunted place in Italy because of two separate historical events.

“In the late 1800s, the area’s mentally ill resided in an asylum on Poveglia. The asylum was poorly constructed and used as a place of exile rather than rehabilitation. There are rumors that in the 1930s, a doctor performed strange experiments on the patients here; eventually the doctor went mad and threw himself from the asylum’s tall bell tower.”

Earlier, “in 1348 the Bubonic Plague arrived in Venice and Poveglia, like many other small islands, it became a quarantine colony.” It is this early event that we will discuss Poveglia Island and related it to film and psychiatry.

Related Film: The Fog (1980)


The Fog is a film directed by John Carpenter told as a campfire tale about a town haunted by corpses from a 100-year-old shipwreck. The fishermen’s legend foretells that at midnight on April 21, when the fog rolls in, corpses will arise from the sea in search of the campfire that originally “lead them to their dark, icy death.”

The movie is set in Spivey Point, 1980, where local fishermen spot a ghost ship carrying corporeal undead. While the US culture has focused on vampires, skeletons, mummies, and zombies, The Fog likely depicts undead fiends from Norse mythology; draugrs. Literally “after-walker,” draugrs are undead creatures that guard treasures (derivation of the term Dragon). Draugrs can rise from the grave as wisps of fog, possess superhuman strength, have the ability to control the weather, and curse a victim.

On the centennial anniversary of the Antonio Bay, a local radio DJ is given a piece of driftwood inscribed with the word “DANE.” In addition to being the name of the ill-fated ship, the inscription also establishes Norse mythology as the origin of the curse. To establish the town charter, 6 townspeople deliberately sunk the ship owned by a wealthy man with leprosy who wanted to establish a leper colony. As guardians of treasures after death, draugrs will exact revenge on the descendants who deliberately murdered, plundered, and founded the town of Antonio Bay.

How it relates to the field of psychiatry

The ability to curse a victim is the major theme of another nautical tale: The Rime of the Ancient Mariner, a Samuel Taylor Coleridge poem inspired by the Flying Dutchman, a ghost ship captained by Vanderdecken. In The Rime of the Ancient Mariner, a ship encounters the ghostly Flying Dutchman. On board are Death (actually, the undead; a skeleton) and the “Life-in-Death” (a deathly-pale woman) playing dice for the souls of the crew. Life-in-Death wins the life of the Mariner; he will endure a fate worse than death as punishment for his offense (killing the albatross). As penance for shooting the albatross, the Mariner is forced to wander the earth and tell his story, teaching a lesson to those he meets.

Since The Fog is told as a campfire tale, the storyteller’s character parallels that of the Mariner who was forced to wander the earth and tell his story. The storyteller’s cautionary tale is that we are the product of our early experiences. While set in the fictional town of Spivey Point, the story’s real setting is the vast ocean and all of its mystery. Just as all the danger lies below the ocean’s surface, so too do our early experiences shape our unconscious (subcortical hippocampus and amygdala).

In Coleridge’s poem, the Mariner is cursed by Life-in-Death for killing an albatross. In Carpenter’s adaptation, the town of Antonio Bay is cursed for its own “albatross”; in 1880, 6 of the town founders deliberately sank a clipper ship named the Elizabeth Dane. The ship was owned by a wealthy man named Blake, who wanted to establish a leper colony near Antonio Bay. One foggy night, the 6 conspirators lit a fire on the beach near treacherous rocks. Deceived by the false beacon, the ship crashed into the rocks and perished.

Anthony Tobia, MD. Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Capuchin Catacombs

Destination 11: Capuchin Catacombs


“Found on the outer limits of the city, the Capuchin catacombs hold the remains of over 8000 souls, their disembodied shells propped up against the walls or resting in open caskets. Down in the cold, dry basement of the monastery, the relentless march of decomposition takes its sweet time. Though some bodies have been reduced to skulls and bones, the majority of corpses are still rotting, and their half-decomposed husks are the stuff of nightmares.”

The state of decomposition in the Capuchin catacombs parallels that of Mercy Brown: one of the most infamous cases of the exhumation of a corpse in order to perform rituals to banish the undead. Details of the Mercy Brown vampire incident may be found here. For purposes of this post, it is important to know that the proceedings of 1892 Rhode Island in part inspired the creation of Bram Stoker’s Dracula.

Related Film (novel): Dracula (1897)


Inspired by Lord Byron’s Fragment of a Novel (1819), John Polidori’s novella, The Vampyre, introduces the mysterious Lord Ruthven and his interludes with Aubrey around Europe. In Greece, Ruthven is mortally wounded when the pair is attacked by bandits. Before he dies, Ruthven makes Aubrey swear an oath that he will not mention his death for a year and a day. Aubrey returns to London and is astounded when Ruthven reappears seemingly unharmed.

Aubrey soon realizes that everyone whom Ruthven meets ends up suffering. Aubrey’s discovery exposes Ruthven’s deceitfulness as evidenced by his repeated lying and conning others for personal pleasure. As he seduces Aubrey’s sister, Aubrey is rendered helpless when Ruthven reminds him of his oath. Ruthven and Aubrey’s sister are engaged to marry on the day the oath ends. Just before he dies, Aubrey writes a letter to his sister revealing Ruthven’s history, but it does not arrive before the wedding vows. On the wedding night, the new bride is discovered dead having been drained of her blood with Ruthven having mysteriously vanished.

How it relates to the field of psychiatry [1]

The origins of one of the greatest myths depicting Antisocial personality Disorder: The Mercy Brown vampire incident, John Polidori’s novella, and texts such as An Extraordinary and Shocking History of a Great Berserker Called Prince Dracula served as inspiration for Abraham “Bram” Stoker’s Dracula. Stoker’s working papers for Dracula were discovered in the Rosenbach Museum in Philadelphia, confirming that he knew about the existence of the “Voivode Dracula,” with Stoker subsequently changing his vampire-creation’s original name, Count Wampyr, to “Dracula” after reading An Account of the Principalities of Wallachia and Moldavia.

In 1389, Mehmed II sent 10,000 cavalry to defeat Vlad III when Vlad refused to pay “jizya” (tax) to the sultan. Passing through a narrow pass north of Giurgiu, Vlad launched a surprise attack, surrounding the Turks and capturing thousands. Vlad’s military tactics serve to teach trainees that while not all violence rises to the level of antisocial personality, even in times of war, it is by no means necessary that “combatants exhibit abnormalities of personality.” Such is the case with Vlad III who upon impaling thousands of the Sultan’s men on wooden stakes, became known as Vlad the Impaler. In Stoker’s novel, this battle is referenced by Van Helsing when describing Count Dracula, “He must, indeed, have been that Voivode Dracula who won his name against the Turk, over the great river on the very frontier of Turkey-land.” Following the killing of Mehmed II, Vlad III wrote to Matthias Corvinus, King of Hungary. His letter illustrates his lack of remorse in committing these heinous acts:

I have killed peasants men and women, old and young, who lived at Oblucitza and Novoselo, where the Danube flows into the sea, up to Rahova, which is located near Chilia, from the lower Danube up to such places as Samovit and Ghighen. We killed 23,884 Turks without counting those whom we burned in homes or the Turks whose heads were cut by our soldiers.


  1. Tobia, A., Katsamanis, Draschil, T., Sportelli, D., M., Williams, J. The Horror!: A Creative Framework to Teach Psychopathology Via Metaphorical Analyses of Horror Films, Academic Psychiatry, March/April, 2013

Anthony Tobia, MD. Copyright © 2018 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Auschwitz Death Camp

Destination 13: Auschwitz Death Camp

Located on a former military base in southern Poland, Auschwitz, the largest of all the Nazi death camps, opened in the spring of 1940. Under the direction of Eduard Wirths, prisoners were subjected to unethical human experiments.

Related Film: The Human Centipede (2009); The Skin I Live In (2011)


While both Doctors Heiter and Ledgard portray “mad scientists” synonymous with human rights violations, we choose to focus on Robert Ledgard. In The Skin I Live In, Ledgard abducts, physically abuses, and psychologically tortures someone he believes drove his daughter to suicide. His prisoner becomes the subject for Ledgard’s human experiments previously rejected by the medical establishment.

How it relates to the field of psychiatry


Badly burnt and disfigured in a terrible car crash, Gal lived in total darkness. One day, she hears her daughter, Norma, singing in the garden. When she walks over to the balcony to find her daughter, Gal accidentally saw her own reflection in the window. Traumatized by the sight, she jumped to her death.

Posttraumatic Stress Disorder

Witness to her mother’s suicide, Norma was recently discharged from an 8-year inpatient psychiatric hospitalization. Later, she demonstrates an exaggerated startle response when Vincent forcibly pins her to the ground. The traumatic event acts as a precipitant for her suicide, as Norma kills herself in the same manner that her mother did.

Cluster B Personality Disorders

Robert Ledgard personifies arrogance and haughtiness, traits that define the Narcissistic Personality Disorder. His grandiosity results in the abduction of Vera (explained next). While imprisoning her, Ledgard demonstrates a disregard for and violation of Vera’s rights. This hallmark of Antisocial Personality Disorder allows for The Skin I Live In to be formulated as a case study of sociopathy.

Gender Dysphoria

[Spoiler alert] At the end of the film, it is revealed that Vera is Vincent. Having blamed Vincent for his daughter’s death, Ledgard tortured him by performing radical gender reassignment surgery, making him in the image of his deceased wife, Gal. While the portrayed torture bears no relation to Gender Dysphoria (GD), Vincent’s marked dysphoria and incongruence between his experienced gender (male) and that assigned by Ledgard (female) reinforces the DSM-5 definition of GD.

Anthony Tobia, MD. Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Odessa Catacombs, Ukraine

Destination 14: Odessa Catacombs, Ukraine

The Odessa Catacombs are the backdrop for the tragic tale of Masha, an innocent partygoer who ventured down into the depths of the catacombs with some friends, took a wrong turn, and was never heard from again. Despite there being little documentation to support the legend, Masha only added to the mythology of the Ukrainian landmark. The lure of the Odessa Catacombs is multidimensional; among many, there are rumors that there’s a solid gold replica of the Titanic.

Related Film: Movie: As Above, So Below (2014)


In search of the legendary philosopher’s stone capable of turning metal into gold and granting eternal life, Scarlett Marlowe discovers the Rose Key. With the key, Scarlett translates a headstone that leads her to believe the philosopher’s stone is hidden 370 feet underneath the streets of Paris.

How it relates to the field of psychiatry

The legend and film differ with regard to the motivation behind the respective ventures into the catacombs. Where as in the Ukraine, Masha’s intent is unknown; Scarlett Marlowe is in search of buried treasure and eternal life. Scarlett’s quest just so happens to characterize two traits that “prove the existence” of a witch (underlined). Is Scarlett Marlowe a witch? Was her character based on Adrienne d’Heur?

Similar to the movie, Adrienne d’Heur lived in France. Interestingly, she was also intelligent, well-educated, and accused of having murdered her husband (in the film, the mysterious death of the heroine’s father replaces that of the husband). Scarlet’s fascination with alchemy may have been inspired more by her husband, Pierre Bacqueson, being a goldsmith than a solid gold replica of the Titanic.

Films that reference witchcraft depict possession and therefore serve as metaphors for dissociation. Accordingly, these films may be viewed as illustrations of mental disorders including dissociative and related disorders (e.g. feeding and eating disorders). The Feeding and Eating Disorder section of the DSM-5 includes feeding and eating disorders of infancy or early childhood as well as 3 specific diagnoses including Anorexia Nervosa and Bulimia Nervosa. Extensive research followed the dissemination of preliminary criteria for Binge Eating Disorder in Appendix B of DSM-IV, and findings supported the clinical utility and validity of its inclusion in the DSM-5.

Anthony Tobia, MD. Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Snake Island, Brazil

Destination 10: Snake Island, Brazil

Off the shore of Brazil lies an island untouched by humans known as “Snake Island.” Researchers estimate that there are five snakes per square meter. The snakes are a family of pit vipers – the golden lanceheads. Locals in Brazil love to recount two grisly tales of death on Snake Island that can be found at

Related Film: Sinister (2012)


Sinister is a 2012 supernatural horror film chronicling the existential crisis of Ellison Oswalt, a fictional crime author who is trying to resurrect his fledgling career. Following an opening scene that shows an unnamed family being hanged from a tree, we meet the Oswalts who are moving into their new Pennsylvania home. On moving day, they are met by the town sheriff, who after admonishing his deputy for soliciting an autograph, tries to convince Ellison to load his boxes back onto the moving truck and leave. The sheriff ‘s warning, a harbinger, serves as foreshadowing of the Oswalts’ fate, as it is ultimately learned that the house they are moving into is the former “Stevenson home;” a Pennsylvania house that’s become an urban legend because it was the site of the horrific hanging depicted in the movie’s opening scene.

While Sinister isn’t set on an island, the film does focus on a snake. A professor of occult crimes informs us that a snake, scorpion, and dog are the precursors to the arrival of Bugghul, a demonic entity who feeds on the souls of children.

How it relates to the field of psychiatry

Approximately 90 minutes into the film, Deputy So and So contacts Ellison to inform him that he’s discovered the pattern of the murders. If the deputy’s explanation is deemed unreliable, the entire plot changes and allows for a diagnostic formulation that promotes Sinister as a movie depicting severe mental illness. For the full text article that explains how the plot of Sinister may be manipulated to depict a case study of the dissociative disorders, click here.

Anthony Tobia, MD, Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.